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Mr. Prior: I am not an expert on hospitals or medicine. I can only repeat the views of the clinicians who have worked in north Norfolk, the general practitioners who will form the new primary care group, the experts in geriatrics at Norfolk and Norwich hospital, and now the independent firm of research consultants. They have come up with requirement levels for north Norfolk that are vastly different from those of the health authority.
Mr. Hutton: I shall come to that issue in a moment. My understanding is that the health authority, having
commissioned that independent research, is now reviewing its strategy in the light of it. It would be premature to speculate and try to predict the results of that reconsideration ahead of the meeting on 25 November.
As I have said, I understand that 458 beds are covered by the review. Some 207 are in north Norfolk, 173 are in south Norfolk, 48 are in the Great Yarmouth area, but only 30 are in Norwich--the largest centre of population in the county. Only 27 out of 86 GP practices in east Norfolk have direct access to GP beds. I understand that no Norwich-based GP can refer direct to a community bed. That need to provide an equitable, quality service is the driving force behind the health authority's strategy.
The draft strategy will consider a number of new facilities, including an NHS centre with community beds in Norwich, new rehabilitation units for Norwich and Cromer--to which the hon. Gentleman referred--and day treatment and therapy centres for Norwich, Cromer, Great Yarmouth and Diss or Thetford. In considering the future of the community hospitals, occupancy levels were also considered as part of the strategy review. In north Norfolk, they have not been high. Until recently, figures showed that, of those 458 beds, an average of only about 340 were occupied at any one time.
As I am sure the hon. Gentleman is aware, the Government are committed to providing the first-class national health service that the nation needs for the next millennium, which will provide the best possible balance and range of services for local people. We set out our plans for modernising the national health service in our White Paper last autumn. It is clear that hospitals will need to develop and evolve to meet the changing needs and expectations of the public and clinical advances. In some cases, that will mean building new hospitals; in others, it may mean closing old ones, changing their use, or using hospital facilities in new and different ways.
Hospitals and trusts will need to work more closely together and replace competition with co-operation and a renewed emphasis on improving quality, including national standards and clinical audit. As part of that modernisation programme, the Government have already approved 31 major hospital developments, worth almost £2.4 billion. That is the biggest renewal and modernisation programme in the history of the national health service. As the hon. Gentleman is no doubt aware, the largest private finance initiative health project yet agreed is the £214 million new hospital on the outskirts of Norwich that will serve much of north Norfolk and the hon. Gentleman's constituency. I am sure that he will want to welcome that major investment in the national health service in Norfolk.
The Government do not intend that hospital services will develop and evolve in a vacuum. New national service frameworks will provide a clear structure within which local hospital services should develop. In addition, as my right hon. Friend the Secretary of State for Health
announced recently, we have set up a national beds inquiry to review the needs and best usage of hospital facilities--particularly beds--to provide clear and strategic direction for the NHS locally in planning and developing services.
The Government are committed to the NHS, and have pledged large sums of money, which shows that commitment. Only this week, my right hon. Friend the Minister of State, Department of Health announced £180 million of capital investment for the new Eastern region next year. Last week, we announced a cash increase of £22.9 million for East Norfolk in its allocation for next year--a real-terms increase of nearly 4 per cent.
I am surprised that the hon. Member for North Norfolk failed to refer to that, but he did mention what he thought were pressures on social services budgets. It may be of interest to him that, under the terms of the comprehensive spending review, we were also able to announce significant increases for social services over the next three years, amounting to £3 billion. In addition to all that extra cash, for this year £3.2 million has been pledged to help East Norfolk to tackle waiting lists and winter pressures.
On the role of community hospitals, our White Paper recognised that community hospitals have been sidelined too often in the past. Our aim is to provide a service which offers swift advice and treatment, as close to where people live as possible. Community hospitals will be an important part of delivering such services and may, in many cases, provide an appropriate setting for intermediate care services. They will, however, have to fit into plans for the wider health and social care systems--and meet the same quality standards and fairness and efficiency tests--as other parts of the health care system.
There is no single national blueprint which will suit different localities. That is why it is the job of health authorities to ensure that local services are matched to local needs. There is no doubt that community hospitals, in some form, will have a key role to play--where they are appropriate and can provide a safe, clinically effective and efficient service for their locality. It is right that the future of community hospitals in Norfolk, as elsewhere, should be decided on that basis.
Under our White Paper proposals, primary care groups and trusts will be a focus for better integrating primary and community care services. Clearly, they will have a role in delivering intermediate care services, but the health authority has a strategic role in examining the overall pattern and range of services.
We must take into account whether any change in local health services will improve care for patients, and that applies to community hospitals just as much as to any other part of health service provision. No part of health care stands alone: it is an interconnected system--between primary, community and acute services. How that is delivered will differ from one area to another.
Ministers can become involved only if a local community health council objects to any of the proposals. Until such time, we must remain objective and impartial. In its draft strategy, the health authority states that the quality of patient care matters most. It is also a matter of equity. Those are both tenets to which the Government
clearly subscribe, and the Anglia and Oxford regional office--and, subsequently, the Eastern regional office--will be monitoring the situation to ensure that those considerations prevail.
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